SARS并发股骨头坏死的发病特点分析及临床意义

Analyses of attacking characteristics and clinical significance about osteonecrosis of the femoral head secondary to SARS

目的 :探讨SARS并发股骨头坏死的临床发病特点。方法 :对 86例经激素治疗后痊愈的SARS康复患者的病史、临床表现、体征 ,以及相关影像和生化检查资料 ,进行统计、分析和总结。结果 :86例患者中 ,确诊为股骨头坏死 4 6例 ,发病率达 5 3 5 % ,其中男性 12例 ,女性 34例。在确诊的病例中 ,4 1例 3～ 6个月内双侧发病 ;4 3例患者没有明显临床症状 ;所有病例普通X线均无异常表现而MRI都有明显异常表现 ;有 7例伴有同侧股骨干和髌骨坏死 ,3例肱骨头出现坏死 ;血浆脂质出现不同程度的异常变化。结论 :SARS并发的股骨头坏死具有发病率高 ,发病快 ,MRI和血脂指标变化明显等发病特点。MRI早期变化明显 ,可作为诊断的重要依据。

Objective:To explore the clinical attacking characteristics in osteonecrosis of the femoral head secondary to SARS.Methods:86 cases of SARS patients who were cured with steroid,were followed up in the medical record,clinical characteristics,image and biochemical examination,and then applied statistical comparison and summarization.Results:In the group,there were 46 cases of osteonecrosis of the femoral head,incidence of the disease was 53.5%,among them,included 12 males and 34 females.In these 46 cases,there were 41 cases attacked with osteonecrosis of both femoral head for 3 to 6 months.There were 43 cases without any clinical symptom.The X-ray examination of these 46 cases were normal while the MRI examination were abnormal obviously,among them,include 7 cases with osteonecrosis of the thigh and knee and 3 cases with osteonecrosis of humeral head the caput humeus.The blood plasma lipid examination was abnormal.Conclusion:There were special attacking characteristics,such as high incidence of disease,rapid attack,obvious changes of MRI and the blood plasma lipid etc,in the osteonecrosis of the femoral head secondary to SARS.MRI can be used in early diagnosis,for its significant changes.